Investigating the Potential Influence of Established Multiple-Choice Test-Taking Cues on Item Response in a Pharmacotherapy Board Certification Examination Preparatory Manual: A Pilot Study

Objective. To determine the prevalence of established multiple-choice testtaking correct and incorrect answer cues in the American College of Clinical Pharmacy's Updates in Therapeutics: The Pharmacotherapy Preparatory Course, 2005 Edition, as an equal or lesser surrogate indication of the prevalence of such cues in the Pharmacotherapy board certification examination.

Methods. All self-assessment and patient case question-and-answer sets were assessed individually to determine if they were subject to selected correct and incorrect answer cues commonly seen in multiple-choice question writing. If the question was considered evaluable, correct answer cues—longest answer, mid-range number, one of two similar choices, and one of two opposite choices—were tallied. In addition, incorrect answer cues— inclusionary language and grammatical mismatch—were also tallied. Each cue was counted if it did what was expected or did the opposite of what was expected. Multiple cues could be identified in each question.

Results. A total of 237 (47.7%) of 497 questions in the manual were deemed evaluable. A total of 325 correct answer cues and 35 incorrect answer cues were identified in the 237 evaluable questions. Most evaluable questions contained one to two correct and/or incorrect answer cue(s). Longest answer was the most frequently identified correct answer cue; however, it was the least likely to identify the correct answer. Inclusionary language was the most frequently identified incorrect answer cue. Incorrect answer cues were considerably more likely to identify incorrect answer choices than correct answer cues were able to identify correct answer choices.

Conclusions. The use of established multiple-choice test-taking cues is unlikely to be of significant help when taking the Pharmacotherapy board certification examination, primarily because of the lack of questions subject to such cues and the inability of correct answer cues to accurately identify correct answers. Incorrect answer cues, especially the use of inclusionary language, almost always will accurately identify an incorrect answer choice. Assuming that questions in the preparatory course manual were equal or lesser surrogates of those in the board certification examination, it is unlikely that intuition alone can replace adequate preparation and studying as the sole determinant of examination success.